解离剂(英语:Dissociative)是致幻剂的亚类之一,能扭曲视觉和听觉感知,并能产生脱离环境与自我的解离效果。虽然许多种类药物都能产生解离,但解离剂的独特之处,在于其产生解离效果的方式,而其中可能包括解离、感官体验淡漠、幻觉、梦境与麻醉。[1]

虽说大多数解离剂的主要作用机制与NMDA受体的拮抗作用有关,但解离剂中的一些物质,也会非选择性的作用影响于多巴胺[2] 或阿片[3]系统,因而可能会产生更直接与可重复的兴奋感与症状,此类典型的“硬性毒品”,或常见滥用药物的效果更为相似。这或许为解离性药物被认为有一定成瘾性之因,并且使其与迷幻药形成区别。尽管某些解离性药物,如苯环己哌啶具有刺激性,但多数解离药,具有抑制作用,可产生镇静、呼吸抑制、恶心、迷失方向、镇痛、麻醉、共济失调、认知和记忆障碍以及失忆等的症状。

效果

解离剂的作用包括感觉解离、幻觉、躁狂、催眠、镇痛与失忆。[4][5][6]据彭德(Pender,1972)所说“因为病人似乎真的与周遭环境分离了,因而这种(解离的)状态被称为解离性麻醉。”[7]彭德(Pender,1970)和约翰斯顿(Johnstone,1959)等人都曾报告,使用氯胺酮苯环己哌啶麻醉的患者,在麻醉期间与麻醉后容易出现无目的的运动和幻觉(或“梦”),一些患者认为幻觉令人兴奋,而另一些患者对幻觉表示不安。[8]在亚麻醉剂量下,解离剂与其他致幻剂(如麦司卡林LSD赛洛西宾)类似,会改变许多相同的认知和感知过程,因此,这两类经常被用作对比,前者亦被认为具有致幻性。[9][10][11]解离剂与传统迷幻药物(如LSD麦司卡林),在主观体验上最大区别或许在于解离效应,包括:人格解体,即感到自我一部分或全部不真实、与自我脱节或无法控制自己的行为;去人格化,即感觉外部世界不真实或认为自我处于梦境。[12]

用途

医用

在医院等医疗环境中,氯胺酮等许多解离剂,被用作手术或止痛的麻醉剂。不过,由于可能产生致幻作用,因此仅有迫不得已时使用。[13][14]某些吗啡喃解离剂,如右美沙芬,也被以亚精神活性剂量用于抑制咳嗽。[15]

作为一种可能的速效抗抑郁剂的氯胺酮,目前也正在接受研究,并显示出良好的效果。[16][17]它还可作为C-PTSD慢性疼痛的可能的缓和治疗方法之一。[18][19]

娱乐用途

一些解离药物被用于娱乐。如,氯胺酮氧化亚氮俱乐部毒品英语Club drug苯环己哌啶(俗称天使尘)是街头毒品的一种。右美沙芬止咳糖浆也具有解离作用,一些使用者过量使用,以用于娱乐[20]氯仿二乙醚历来也都被用于娱乐。

扩展阅读

参考文献

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